José Saraiva

Lyme disease: sudden hearing loss as the sole presentation

BACKGROUND Lyme disease is an uncommon tick-borne multisystemic infection caused by Borrelia burgdorferi. The most common clinical manifestation is erythema migrans. In this report, a very unusual presentation of this condition is described, in which sudden onset sensorineural hearing loss was the sole presenting symptom. METHODS Case report and review of English-language literature. RESULTS A patient presented with sensorineural hearing loss, with no other symptoms or signs. Acute Lyme infection was detected by laboratory tests. Magnetic resonance imaging showed signs of labyrinthitis of the same inner ear. After hyperbaric oxygen and systemic antibiotic treatment, the patient showed total hearing recovery, and magnetic resonance imaging showed complete resolution of the labyrinthitis. CONCLUSION To our knowledge, this is the first reported case of Lyme disease presenting only with sensorineural hearing loss. Borreliosis should be considered as an aetiological factor in sensorineural hearing loss. Adequate treatment may provide total recovery and prevent more severe forms of Lyme disease.

Microcarcinoma Papilar da Tiroideia - Relato de Caso: Nódulo Tiroideu Acidental - do Diagnóstico ao Tratamento

Thyroid nodules are very frequent on clinical daily basis, and ruling out malignancy, which may play the part in up to 4% a 6.5% of cases, represents their main clinical interest.Evaluating a thyroid nodule will depend on clinical as well as ultrasonography characteristics that will further determine which nodules should undergo fine needle aspiration – cytological result (1 out of 6 possibilities according to Bethesda system) will be the main determinant of therapeutic choice.This is a case report about the evaluation of an incidental thyroid nodule that is cytological indeterminate (follicular lesion of undetermined significance) which proved to be a papillary thyroid microcarcinoma.

Carcinoma de Células Acinares da Parótida: Caso Clínico

We present a case of a parotid tumor – acinic cell carcinoma – involving the superficial and deep lobe, surgically treated with total parotidectomy and then submitted to local and cervical radiotherapy. We have chosen this case due to the fact that the tumor involved both the superficial and deep lobe, without involving the facial nerve. This putted a bigger surgical challenge, which was the removal of the tumor and the gland preserving the nerve and its branches.At CUF Descobertas Hospital, the treatment of patients with head and neck cancer is assured by the multidisciplinary collaboration of Otorhinolaryngology, Haemato-Oncology and Radiotherapy departments. Salivary glands tumors are one example, as is the case presented. Received: 02/05/2017 - Accepted: 29/08/2017

Otomastoidite Aguda em Criança

Crianca de 2 anos, sexo masculino, diagnostico de otite media aguda bilateral, medicada inicialmente com amoxicilina + clavulanato 90 mg/kg/dia desde ha 7 dias, internada por agravamento do quadro a esquerda, com edema e eritema retroauricular, apagamento do sulco retroauricular [...] Recebido: 07/09/2015 · Aceite: 7/01/2016

P09.13: Foetal akinesia deforming sequence: two different genetic syndromes

diagnosed prenatally. Pregnant aged 32 years old, the couple are cousins, and they had other 2 healthy children. It was the first time that went to the urgencies of our hospital; the gestational age was 34+6 weeks and she had spontaneous amniorrhexis four hours before. The following echographics findings are observed: agreed fetus with amenorrhoea, polyhydramnios with very dense amniotic fluid that produces level by its deposit in parts declivities, fetus in attitude of flexion with little mobility, very ecogenic fetal tegument, of redundant aspect mainly at level of back and members. Depressed nasal bridge. Other malformations were not seen and congenital icthyosis was suspected. 12 hours later, a woman of 2800 gr of weight was born by caesarean section, without external or internal malformations, except for a generalized hyperkeratosis distributed in plates. After the birth a progressive fall of the hyperkeratosic plates took place, being heavy, rough and dry skin. At the moment, the baby counts 2 months of age and she is well, being pending some specific studies (hystopatologics and ultrastructural studies of the skin). The prenatal and postnatal images are contributed.